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目的探讨血清β痕迹蛋白(βTP)在老年T2DM肾损害中应用价值。方法将131例老年T2DM患者分为尿白蛋白正常(NUAlb)组,微量尿白蛋白(MUAlb)组和大量尿白蛋白(CUAlb)组,另设健康对照(NC)组40名。采用胶乳增强散射免疫比浊法检测血清βTP,并与血肌酐(Scr)、胱抑素C(CysC),评估肾小球滤过率(eGFR)等指标进行相关性分析。结果 NUAlb组血清βTP水平高于NC组(P<0.05)。NUAlb组、MUAlb组、CUAlb组血βTP、CysC、Scr阳性率分别为32.5%、30.0%、0.0%,64.0%、60.0%、12.0%和87.8%、90.2%、29.3%;3组血βTP、CysC阳性率均显著高于Scr,但βTP、CysC之间差异无统计学意义。相关分析表明,血βTP与CysC、Scr、病程、SBP及UA呈正相关,与eGFR呈负相关,与HbA1c、FPG、DBP、BMI不相关。结论血清βTP对老年T2DM肾损害评价有一定意义,其诊断敏感性优于Scr,有可能成为评价肾小球滤过率新的血清学标志物。
Objective To investigate the value of serum β-trace protein (βTP) in the diagnosis of renal damage in elderly patients with T2DM. Methods One hundred and thirty-one elderly patients with T2DM were divided into two groups: NUAlb group, MUAlb group and CUAlb group, and another 40 healthy control subjects (NC). Serum βTP was detected by latex enhanced immunoturbidimetric assay, and the correlations were analyzed with serum creatinine (Scr), cystatin C (CysC) and glomerular filtration rate (eGFR). Results The level of serum βTP in NUAlb group was higher than that in NC group (P <0.05). The positive rates of βTP, CysC and Scr in NUAlb, MUAlb and CUAlb groups were 32.5%, 30.0%, 0.0%, 64.0%, 60.0%, 12.0% and 87.8%, 90.2% and 29.3% CysC positive rate was significantly higher than Scr, but there was no significant difference between βTP and CysC. Correlation analysis showed that serum βTP was positively correlated with CysC, Scr, course of disease, SBP and UA, negatively correlated with eGFR, but not with HbA1c, FPG, DBP and BMI. Conclusion Serum βTP has some significance in the evaluation of renal damage in elderly patients with T2DM, its diagnostic sensitivity is better than that of Scr, which may become a new serological marker for evaluating glomerular filtration rate.